Health Insurance Remains a Mirage to Nigerians as 80 Percent Pay Out of Pocket.
Abuja, Nigeria. 12th November 2022. A new public opinion poll conducted by NOIPolls has revealed that most Nigerians pay out of pocket for healthcare at various healthcare facilities across the country as disclosed by 80 percent of adult Nigerians nationwide. While 3 percent reported that their health services are paid for by family and friends, only 17 percent of adult Nigerians claimed to have access to health insurance cover.
This implies health insurance cover has remained abysmal despite the availability of National Health Insurance Scheme (NHIS) which was established in 2006 to achieve Universal Health Coverage (UHC) in Nigeria with financial risk protection mechanisms.
Furthermore, the poll result revealed that out of the 80 percent who pay out of pocket to access healthcare, 57 percent are willing to pay money monthly or yearly to get enrolled into the health insurance scheme. This also suggests access is a major issue with regards to health insurance coverage across the country.
Therefore, there is need for a defined, definite, and deliberate approach towards mass enrolment of Nigerians, as well as intensive sensitization by relevant stakeholders as almost half of adult Nigerians (49 percent) disclosed that they are unaware of the National Health Insurance Scheme. This will go a long way in reducing the incidence of out-of- pocket payment and incurring catastrophic health expenditure. These are some of the key findings from the Health Insurance poll conducted in the week commencing November 14th, 2022.
The Universal Health Coverage Day is marked 12 December annually to call on leaders to make smarter investments and accelerate efforts towards health for all.
This years’ theme is “Build the world we want; A healthy future for all,” and it is hashtag #HealthForAll emphasizes that to build strong health systems we need equity, trust, healthy environments, investments, and accountability. In the world we want, everyone everywhere should have access to quality healthcare whenever they need it without suffering financial hardship.1 Against the background, NOIPolls conducted a public opinion poll to feel the pulse of Nigerians regarding healthcare insurance in the country.
The first question focused on self-assessment of the health status of adult Nigerians nationwide. The poll result revealed that most Nigerians (90 percent) believe that they are healthy whereas 10 percent think otherwise.
The next question sought to know what Nigerians do when they fall ill. The findings showed that majority of adult Nigerians (87 percent) claim that they visit the hospital when ill. Analysis by geographical locations shows that the North-West (98 percent) zone accounted for the larger proportion of Nigerians who have the same view.
On the other hand, 13 percent stated that they do not visit the hospital when ill and respondents from the South-South (29 percent) zones had more people with this assertion.
Respondents who claimed that they do not go to hospital when ill were further probed and findings from the poll revealed that 44 percent visit a pharmacy, 39 percent visit a chemist, 19 percent self-medicate, and 9 percent go to a traditional doctor when ill.
Furthermore, respondents who mentioned that they go to the hospital when ill were further probed as well. The poll findings showed a high utilization of public hospitals across the country as disclosed by 58 percent of adult Nigerians who stated they visit public hospitals when ill. In addition, while 36 percent utilize private healthcare facilities, 5 percent disclosed that they utilize both public and private healthcare facilities.
In addition, Nigerians who visit healthcare facilities were further asked on how they pay for their health care. Irrespective of the healthcare facilities they visit when ill, a very high proportion of adult Nigerians (77 percent) nationwide disclosed that they pay out of pocket for healthcare services.
On the contrary, only 17 percent of adult Nigerians acknowledged that they have health insurance cover. This suggests that health insurance has remained very low in Nigeria despite the National Health Insurance Scheme (NHIS) which
was established in 2006 to achieve Universal Health Coverage (UHC) for Nigerians with financial risk protection mechanisms.
Subsequently, of the 17 percent who indicated that they access health insurance, 75 percent mentioned they access healthcare services through the NHIS. Similarly, 25 percent disclosed that they access care through private health insurance organizations.
In terms of patient’s satisfaction, 82 percent of those who are under health insurance reported that they are satisfied with the services provided by the health insurance provider whereas 18 percent stated otherwise.
Consequently, respondents who do not have any form of health insurance were asked if they are aware of the National Health Insurance Scheme (NHIS) and 51 percent of respondents acknowledged that they are aware of the scheme whereas 49 percent said no.
The poll further gauged the willingness of Nigerians who currently pay out-of-pocket to pay money monthly or yearly to access healthcare services whenever they need it. The poll result showed that 57 percent of the respondents revealed that they are willing to pay money monthly or yearly to get enrolled into the health insurance scheme. On the flipside, 43 percent of the respondents did not express willingness to be enrolled on the health insurance scheme.
The poll result has shown very high proportion of adult Nigerians still pay out-of-pocket for healthcare. Evidence shows that some healthcare expenditure can push people further into poverty. A way to reverse this high out-of-pocket payment is for government, at all levels in Nigeria, to accelerate the push for Universal Health Coverage. This will lift people out of poverty, promote the well-being of families and communities, protect against public health crises, and move them toward health for all.
The poll shows an urgent need for interventions in the Nigerian health system to reduce the incidence of out-of-pocket health expenditure. The proportion of the population covered by financial risk protection in healthcare utilization is too low at 17 percent, compared to a benchmark of 90 percent for an efficient health system, and this reflects how far Nigeria lags in the race toward universal healthcare coverage. Finally, there is need for a definite and deliberate approach towards mass enrolment of Nigerians by relevant stakeholders as well as intensive sensitization as almost half of adult Nigerians (49 percent) disclosed that they are not aware of the National Health Insurance Scheme. This will go a long way in reducing the incidence of out-of-pocket payment and incurring catastrophic health expenditure.
The opinion poll was conducted in the week commencing November 14th, 2022. It involved telephone interviews of a proportionate nationwide sample of 1,000 randomly selected phone-owning Nigerians aged 18 years and above, representing the six geopolitical regions and 36 states and the FCT of the country. Interviews were conducted in 5 languages – Igbo, Hausa, Yoruba, Pidgin English, and English. Although we can say with 95% confidence that the results obtained were statistically precise – within a margin of error of plus or minus 4.65%; we recognize that the exclusive use of telephone polling has its limitation of excluding non-phone-owning Nigerians. Nonetheless, with the country’s tele density put over 100 percent by the Nigerian Communications Commission (NCC), we consider our telephone polling approach appropriate. Also, given the rigorous scientific process of randomization and stratification applied, we can confidently stand by the validity of our methodology and approach.
NOIPolls Limited, No1 for country-specific polling services in West Africa. We conduct periodic opinion polls and studies on various socio-economic and political issues in Nigeria. More information is available at www.noi-polls.com.
This press release has been produced by NOIPolls Limited to provide information on all issues which form the subject matter of the document. Kindly note that while we are willing to share results from our polls with the public, we only request that NOIPolls be acknowledged as authors whenever and wherever our poll results are used, cited, or published. NOIPolls hereby certifies that all the views expressed in this document accurately reflect the views of respondents surveyed for the poll, and background information is based on information from various sources that it believes are reliable; however, no representation is made that it is accurate or complete. Whilst reasonable care has been taken in preparing this document, no responsibility or liability is accepted for errors or fact, or any views expressed herein by NOIPolls for actions taken because of information provided in this report. Any ratings, forecasts, estimates, opinions, or views herein constitute a judgment as at the date of this document. If the date of this document is not current, the views and content may not reflect NOIPolls’ current findings and/or thinking.
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